Tiny Tigers
I have talked with so many women in perimenopause with all kinds of uncomfortable symptoms: Hot flashes, vaginal dryness, urinary incontinence, pain with sex, insomnia.
The labs come back normal, and their doctors tell them one of a few things:
- Take HRT (hormone replacement therapy)
- Do your kegels
- This is aging, deal with it
Obviously there are so many things wrong with this advice.
HRT
Some holistic practitioners are 100% on board with HRT, others will gaslight you for not doing life the "all natural" way.
I take a more nuanced perspective. It certainly isn't for everyone, and it most certainly is not a standalone therapy. It must be used in conjunction with a healthy liver and bowel function. And we cannot ignore that the perimenopause symptoms we experience are often signs of the ways we have been living out of balance -- overgiving, staying in toxic relationships, ignoring our own needs.
Perimenopause is actually an invitation to listen deeply, and make essential shifts in how we are living and treating ourselves. AND sometimes we have gotten ourselves so far askew in this realm, that HRT (Hormone Replacement Therapy) also these days called MHT (Menopause Hormone Therapy), can really support us to find our ground.
Kegels
Kegels have been fed to us as the mainstay, and often ONLY recourse for issues of incontinence. In some cases of generalized weakness, Kegels, when done properly, can help with incontinence.
However, I see WAY MORE issues of imbalanced muscle activity as well as tension patterns in the pelvic bowl. For these issues, kegels can actually exacerbate the problem. What we really need to do here, is learn to soften and let a few more of those tiny tigers melt away.
This is aging, deal with it
There is enough wrong with this statement, that I could write a whole book. We all can, right?
First, if you're having your estrogen checked: it fluctuates daily in perimenopause, so taking one reading at face value — and making decisions based on it — isn't the full picture.
Cortisol is another number worth catching, though it's notoriously hard to get an accurate read on via blood.
And yet, this is also not really about numbers, but I will address this on a practical level for a moment.
Here's why elevated cortisol matters, whether or not you can easily test for it.
Elevated cortisol suppresses progesterone, and has a mixed effect on estrogen. And in our current world, women carry more stress load than ever — we go out and earn, and many of us still carry a disproportionate share of the work to maintain our homes.
Our stress response was designed for a proverbial tiger. We get chased, and either we get eaten, or we find safety and the stress response resolves.
In our current world, we have the tiny tigers of misogyny, adorable children, aging parents, work, maybe entrepreneurial pursuits, friendships to maintain, homes and gardens to tend, racism, climate change, political upheaval.
Without dialing in the ways we tend ourselves and our nervous systems, we will never get a break from the ways the world can make us feel so vigilant. It is a trick to tend ourselves in the most loving ways, both in the practical / physical realm and the emotional / spiritual realm, without that simple tending being another act of vigilance and stress.
One simple recommenda
One Simple Takeaway
If you are to walk away from this article with one takeaway. One simple place to start. When our systems get out of balance, it can feel overwhelming to make many changes at once, so a great way to build trust in yourself AND pave the pathway to long term sustainable change, PICK ONE SIMPLE LIFESTYLE SHIFT AND COMMIT.
Here is one of my favorites. Commit to staying off of your phone after 9 pm, and see if you can spend at least a few minutes outside first thing in the morning, before checking the email and responding to all the things. They will still be there. Let yourself regulate in nature for just a few minutes first as a way to attune to the day you want to have.
One of my greatest joys is to support women in making these shifts over time, to heal incontinence and pelvic pain. Book a clarity call below if you'd love to explore working together.
About Chaya Aronson
Chaya Leia Aronson, RN BSN is a bodyworker, health and sexuality coach, dancer, lover and mother. Chaya believes that we source our creative, life force expression through our pelvic bowls and if the energy is blocked here, it greatly affects our capacity to be our full authentic selves in the world. Her passion is to support pelvic and abdominal health and healing. The main forms of bodywork she practices are the Arvigo Techniques of Maya Abdominal Therapy® and Holistic Pelvic Care™. Bellydance, contact improvisation and yoga have been the central core of her spiritual and physical practice for over 20 years. She weaves the knowledge she’s gained about movement patterns and body structure with her playful and intuitive spirit to support her clients in actively healing their own bodies and spirits.